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[Translated article] Cost-utility of sacubitril/valsartan in heart failure with reduced ejection fraction in Spain

Antonio García-Quintana1, Héctor Alonso Ramos2, Javier Parrondo3

  • 1Servicio de Cardiología, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain.

Farmacia Hospitalaria : Organo Oficial De Expresion Cientifica De La Sociedad Espanola De Farmacia Hospitalaria
|August 23, 2025
PubMed

Insights

Starting sacubitril/valsartan in hospital for heart failure patients is cost-effective. This new treatment improves life years and quality-adjusted life years compared to enalapril, offering value for the Spanish National Health Service.

Area of Science:

  • Pharmacoeconomics
  • Cardiology
  • Health Services Research

Background:

  • Heart failure (HF) is a prevalent condition with substantial healthcare costs, frequently leading to hospitalization.
  • HF is the leading cause of hospital discharge diagnoses in Spain, highlighting a significant public health burden.

Purpose of the Study:

  • To evaluate the economic impact of sacubitril/valsartan, a novel treatment for heart failure with reduced ejection fraction (HFrEF).
  • To compare the cost-effectiveness of initiating sacubitril/valsartan during inpatient stays versus post-discharge, using enalapril as a comparator.

Main Methods:

  • A Markov model was developed for economic evaluation.
  • Data from the PARADIGM-HF and PIONEER-HF studies were utilized.
  • Key metrics analyzed included total costs, life years gained (LYG), quality-adjusted life years (QALYs), and incremental cost-effectiveness/utility ratios (ICER/ICUR).

Main Results:

  • Sacubitril/valsartan demonstrated improved LYG and QALYs compared to enalapril.
  • The incremental cost-utility ratio (ICUR) was below €20,000/QALY.
  • Initiating sacubitril/valsartan during hospitalization post-decompensation yielded a more favorable ICUR.

Conclusions:

  • Initiating sacubitril/valsartan during hospital admission for heart failure is a cost-effective strategy.
  • This approach is considered cost-effective from the perspective of the Spanish National Health Service.
Abstract

Keywords:
Cost-utility analysisEstudio de coste-utilidadHeart failureInpatientsInsuficiencia cardíacaMarkov chain modelModelo de MarkovOutpatientsPacientes ambulatoriosPacientes hospitalizadosSacubitril/valsartanSacubitrilo/valsartán

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